Analyte stability in whole blood using experimental and datamining approaches.
Author(s): Ziobrowska-Bech A, Hansen AB, Christensen PA
Publication: Scand J Clin Lab Invest, 2022, Vol. , Page 1-8
PubMed ID: 35112638 PubMed Review Paper? No
Purpose of Paper
This paper investigated the stability of lactate dehydrogenase, potassium, and phosphate levels in case-matched blood specimens stored at 17°C, 21°C, or 25°C; in age- and gender-matched blood specimens that experienced different processing delays; and among specimens store initially for 2 h at 17°C, 19°C or 25°C followed by subsequent storage at 21°C.
Conclusion of Paper
Lactate dehydrogenase levels remained within an acceptable level of bias when blood was stored at 17°C, 21°C, and 25°C for up to 10 h; stored for 2 h at 17, 19 or 25°C and then stored at 21°C for up to 8 h; and in specimens analyzed after real world transport and processing delays of up to 10 h. Phosphate levels remained relatively stable when blood was stored at 17°C for 10 h but bias exceeded an acceptable level when stored at 21°C or 25°C for ≥ 7 h; when the real world processing delays was ≥5 h; and, when stored at 21°C for 5 h after initial storage at 17, 19 or 25°C. Potassium levels increased when blood was stored at 17°C for >2 h or when stored for 2 h at 19°C or 25°C followed by 5 h at 21°C, however, changes associated with blood storage at 21°C and 25°C for up to 10 h and in real world specimens subjected to 10 h delay were within an acceptable level of bias.
Studies
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Study Purpose
This study investigated the stability of lactate dehydrogenase, potassium, and phosphate levels in case-matched blood specimens stored at 17°C, 21°C, or 25°C; in age- and gender-matched blood specimens that experienced different processing delays; and among specimens store initially for 2 h at 17°C, 19°C or 25°C followed by subsequent storage at 21°C. Blood was collected from 180 patients (diagnosis not specified) into three lithium-heparin vacutainer tubes and hand delivered to the laboratory. Specimens were stored at 17, 21, and 25°C for 2, 7 and 10 h before centrifugation or stored at 17, 19 or 25°C for 2 h and then stored at 21°C for 0, 5 and 8 h before analysis. Additionally, retrospective analysis was performed for an unspecified number of blood test specimens either collected at a general practitioner’s office, transported to the laboratory at 21 ±1°C, and analyzed within 10 h, or collected at an outpatient clinic and hand delivered to the laboratory. Age- and gender-matched specimens collected at the clinic and analyzed within 3 h were compared to specimens collected at the general practitioner’s office and analyzed within 3 h, 3-4 h, 4-5 h, 6-7 h, 7-8 h, 8-9 h and 9-10 h. Levels of lactate dehydrogenase, potassium and phosphate were measured in all specimens on a Cobas 8000 ISE/c502/c702 module instrument. Levels in the experimental storage specimens were compared to specimens processed as soon as possible.
Summary of Findings:
Phosphate levels remained relatively stable when blood was stored at 17°C for 10 h but decreases of ~10% were noted when specimens were stored at 21°C or 25°C for ≥ 7 h. In contrast, potassium levels increased by >10% when blood was stored at 17°C for >2 h, but remained stable when stored at 21°C or 25°C. Although lactate dehydrogenase levels appeared to increase slightly with blood storage at 17°C or 21°C, levels remained within the minimal bias threshold of 5.11%. In the analysis of clinical specimens, median lactate dehydrogenase and potassium levels remained within the acceptable bias when specimens were processed within 10 h. In contrast, median phosphate levels were greater than the acceptable range of bias when the processing delay was ≥5 h. When specimens were held at 17, 19 or 25°C for 2 h and then stored at 21°C for 0, 5, or 8 h, lactate dehydrogenase levels remained within the expected levels of bias. However, when specimens were held at 17, 19, or 25°C for 2 h the observed increase in potassium exceeded the bias threshold following subsequent storage at 21°C for 0 h, 5 h, and 5 h respectively. Phosphate levels remained within the acceptable range of bias after initial storage for 2 h at any of the temperatures but exceeded the bias threshold with subsequent storage for 5 h at 21°C, regardless of initial storage temperature. Interestingly phosphate levels in specimens initially stored at 19°C were within the bias threshold again after subsequent storage at 21°C for 8 h.
Biospecimens
Preservative Types
- None (Fresh)
Diagnoses:
- Not specified
Platform:
Analyte Technology Platform Electrolyte/Metal Clinical chemistry/auto analyzer Protein Clinical chemistry/auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Storage Storage temperature 17°C
21°C
25°C
17°C for 2 h then 21°C
19°C for 2 h then 21°C
25°C for 2 h then 21°C
Storage Storage duration 0 h
2 h
7 h
10 h
0-3 h
3-4 h
4-5 h
5-6 h
6-7 h
7-8 h
8-9 h
9-10 h